MEDICARE: REIGN SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1700427291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REIGN SERVICES LLC

Provider Business Mailing Address
First Line	:	8230 LONG LAKE RD
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55112-4622
Country	:	US
Telephone Number	:	651-675-8551
Fax Number	:	763-600-6102

Provider Business Practice Location Address
First Line	:	8230 LONG LAKE RD
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55112-4622
Country	:	US
Telephone Number	:	651-675-8551
Fax Number	:	763-600-6102

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MILDA AYINDE
Credential	:
Telephone Number	:	651-675-8551

Provider Enumeration Date	:	10/05/2019
Last Update Date	:	10/05/2019

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Directions to “REIGN SERVICES LLC ” Practice Location

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